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Use the links that follow or scroll down to access articles that focus on this health care related medical information.
Medical Costs: Health Care Trends.
The Blue Cross and Blue Shield Association (BCBSA) has updated the Medical Cost Reference Guide and it is now available online at www.bcbs.com. You can review a copy of the Guide online or you can request a printed copy on the web site.
Healthcare Financing Trends.
The US spends more on healthcare than any other country. Hospitals, physicians and prescription drugs continue to be the top three healthcare spending areas. Three-quarters of the private healthcare dollar goes to these three items. For every private healthcare dollar:
• 31 cents goes to hospital costs.
• 29 cents goes to physician and clinical services.
• 14 cents goes to prescription drugs.
• 14 cents goes to administrative costs.
• 6 cents goes to dental care.
• 3 cents goes to other professional services.
• 1 cent goes to nursing home care.
• 1 cent goes to home health care services.
Employer Based Health Premiums.
In 2003, employers who paid part of the health care premium for employees paid 73.4 percent of the total premium amount. In 2007, employers paid 72.9 percent of the cost of the premium. In addition, the total premium cost for employer based health insurance has increased from $9,068 in 2003 to $12,106 in 2007 for family coverage. The decrease in the employer’s contribution plus the increase in the total premium amount means that employees are paying a larger portion of the total premium amount. The employee’s share for family coverage increased from $2,412 in 2003 to $3,281 in 2007.
Healthcare Spending.
Why is the cost of healthcare increasing? The number of treatments available to diagnose and the ways to manage our illness have increased dramatically in the past ten years.
For example, you can now have an MRI to help diagnose heart problems more completely instead of having an invasive procedure. Then the coronary artery bypass performed to correct your heart problem uses technology that has now become a standard medical procedure that wasn’t available when our parents were our age. The cost and availability of new technologies and the greater use of the technology means higher costs.
In addition, take a moment to think about all the new prescription drugs available today for the treatment of conditions that did not exist or for which there were no treatments 10-15 years ago. There are now many drugs available that treat very specific diseases that only affect a small part of the population. These new drugs cost money to research and develop, and may cost over $5,000 for just one fill of a prescription. These new innovations are great, but they also impact the cost of prescription drugs.
The availability of new technology and new medications affect how much money we pay for healthcare and health insurance. The increasing cost of healthcare means you are paying more in premiums and sometimes even for cost-sharing expenses like deductibles and co-payments.
For more information about healthcare economics, go to www.bcbs.com and click on the Medical Cost Reference Guide. You can also review additional studies conducted by independent researchers about the cost of health care. (Please Note: When you choose this link, you are leaving fepblue.org and going to a new web site. Although this new web site is owned and updated by the Blue Cross and Blue Shield Association like fepblue.org, it does have different privacy policies. Protection of your privacy at the new site is governed by the privacy policy of that site. Therefore, please take time to read the privacy policy of the new site.)
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally published in June 2008. Resources include: Medical Cost Reference Guide, 2008 update; Final Report on the Relationship Between Technology Availability and Health Care Spending, Stanford University and Analysis Group, Inc., November 2005.
Anemia: What You Need To Know.
Anemia is the most common blood condition in the US, affecting over three million people.
What Is Anemia?
Anemia is a condition that develops when your blood does not have enough healthy red blood cells. As you may know, red blood cells are used by your body to transport oxygen to your organs. Hemoglobin is the protein that carries the oxygen from the lungs to the rest of your body. Tiredness, a symptom of anemia, occurs because your organs are not getting enough oxygen. This is important because without enough oxygen you can damage your heart and other organs.
Anemia can also be associated with other medical conditions such as ulcers, cancer or menstrual problems.
If you have a mild form of anemia or it has developed over a long period of time, you may not even notice any symptoms. Common symptoms include:
• Easy fatigue and loss of energy.
• Unusually rapid heart beat, especially when exercising.
• Shortness of breath and headache, especially when exercising.
• Difficulty concentrating.
Are You At Risk?
Your red blood cells may not have enough hemoglobin to carry the oxygen throughout your body. This means your body is not getting enough iron. Usually this means that your diet does not include enough iron rich foods, such as red meat, eggs, beans or dark leafy greens.
Women are at risk to develop iron-deficiency anemia due to blood loss during menstrual cycles and increased blood demands during pregnancy. Seniors may also be at risk due to poor diet and other medical conditions. Individuals involved in chemotherapy or radiation therapy, or who have recently undergone major surgery, may also be at risk.
Treatment.
If you think you may have anemia, you need to see your physician. Only your physician can determine the cause of you anemia and prescribe the appropriate treatment.
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally published in May 2008. Resources include Blue Health Connection on www.fepblue.org, anemia; www.webmd.com, anemia; and www.anemia.org.
Allergy Alert.
Winter is over, and signs of new plant life are everywhere. You step outside, take a deep breath – and are hit by a sneezing attack as your eyes begin to itch and swell. Suddenly, you are unable to breathe through your nose. You may feel like turning around and sealing yourself up inside your home until pollen season is over.
You are not alone. Nearly 36 million people in the US suffer from seasonal allergies, according to the American Academy of Allergy, Asthma and Immunology. Fortunately, there is more help than ever before for seasonal-allergy victims.
What Are Seasonal Allergies?
Allergic conjunctivitis is the most common seasonal allergy affecting the eyes. Its symptoms—itchy, watery, red and swollen eyes—are usually caused by exposure to pollen that accumulates in the air each year. Contact lens wearers may experience additional discomfort resulting from the collection of pollen and allergy-related secretions that bind to their lenses.
If you are one of the unlucky ones who suffer from these unpleasant eye symptoms, you probably are also a victim of seasonal allergic rhinitis—commonly known as hay fever—which defines your nose’s reaction to the same pollen: sneezing, congestion, postnasal drip, runny nose and itchy throat. In fact, pollen can travel through connecting ducts from the eyes to the nose.
Pollen is a fine powder that is released by plants and is carried through the air, sometimes for miles, to another plant of the same type in order to fertilize new seeds. The kind of pollen that causes allergic reactions comes from non-flowering plants, such as trees, grasses and weeds. Pollen from flowering plants does not cause allergy problems because it is delivered by insects rather than by the wind. Generally, pollen season in the U.S. lasts from February or March through October, and starts later in the spring the farther north one goes. In southern states, it can begin in February.
Your body’s allergic reaction to pollen is caused by your immune system’s abnormal response to this dust-like substance. Mistaking harmless pollen for a disease-causing agent, your body begins to produce antibodies to fight it off, just as it would for an attacking virus. The body then releases histamines, chemicals that trigger inflammation and increased secretions of the sinuses, nose and eyes.
Your body’s allergic reaction to pollen is caused by your immune system’s abnormal response to this dust-like substance. Mistaking harmless pollen for a disease-causing agent, your body begins to produce antibodies to fight it off, just as it would for an attacking virus. The body then releases histamines, chemicals that trigger inflammation and increased secretions of the sinuses, nose and eyes.
The Best Treatment: Avoidance.
Doctors agree that the best way to control seasonal-allergy symptoms is to avoid the pollen that triggers them. That means staying indoors when pollen counts are highest. A good rule of thumb is to stay indoors as much as possible on hot, dry, windy days, and on any day between 5 am and 10 am.
When you are outdoors, follow these guidelines:
• Minimize walks in wooded areas or gardens.
• Wear a mask when mowing the lawn or gardening. Better yet, ask a non-allergic person to do your yard work for you. Keep grass cut low (no more than two inches high) to help prevent pollen from reaching into the wind.
• Keep hedges in your yard pruned and thin them to limit collection of pollen on their branches.
• Dry your clothes and linens in an automatic dryer instead of hanging them outdoors.
When you are indoors, maximize your protection by taking these steps:
• Keep windows closed, and use air conditioning both at home and in your car.
• Cover home air conditioning vents with cheesecloth to filter out pollen. Clean air filters frequently (high-efficiency particulate air filters [HEPA] are the best) and clean air ducts at least once a year.
• In your car, set the air conditioning to “recirculate” to keep new pollen-laden air from entering the vents.
Medical Remedies.
If your symptoms are mild, some doctors recommend placing cold compresses directly on your closed eyes for ten to twenty minutes. If that is not effective, visit your local pharmacy and buy an over-the-counter tear substitute, which can lubricate your eyes and help wash the pollen out.
It is important to treat eye allergies with eye medications. They may sometimes help relieve nasal symptoms as well as eye discomfort, by draining from the eye into the nose. It does not work the other way around, however, and nasal sprays are generally prevented by gravity from reaching the eyes.
Eye drops and gels work more quickly and have fewer side effects than oral medicines. In fact, oral antihistamines, while successfully treating nasal allergy symptoms, can actually make eye symptoms worse by drying out your eyes and leaving them with less protection against pollen.
If over-the-counter medication is ineffective, or if you are not sure that your symptoms are caused by an allergy, see your eye doctor. There are a number of very effective anti-allergy prescription eye drops today that are commonly prescribed by optometrists and ophthalmologists. If you wear contact lenses, ask your doctor about drops that can help relieve symptoms while keeping your lenses pollen-free. You may want to try daily disposable contact lenses to avoid the problem of pollen and other irritating deposits building up on your lenses. Another option is to visit an allergy specialist, who can give you a shot that will immunize you against the uncomfortable effects of pollen.
How Do You Know If Your Symptoms Are Caused By An Allergy Or By Another Condition Or Disease?
Both allergies and colds cause symptoms of sneezing, congestion, runny nose, watery eyes, fatigue and headaches. To determine whether you have a cold or an allergy, play close attention to the following, more subtle signs:
• Cold symptoms often appear one at a time. Allergy symptoms occur all at once.
• Cold symptoms usually last from seven to ten days, whereas allergy symptoms continue only as long as a person is exposed to the allergy-causing agent.
• Allergies generally cause clear, thin, watery mucous discharge. Colds may bring on a yellowish nasal discharge, suggesting an infectious disease.
• Sneezing is a symptom more common to allergies, especially when it occurs multiple times in a row.
• If you have a fever, it’s not an allergy.
• Colds are more common during the winter months, whereas allergies are typically triggered in the spring, summer and fall, when plants are pollinating.
• Pay special attention to your eye symptoms. Generally, if your eyes itch, you have an allergy. If your eyes only burn or sting, you may have dry eye. If there is a thick discharge from your eye, you could have an infection. See your eye care provider for proper diagnosis and treatment if you are experiencing any eye discomfort.
Many options exist that will allow you to enjoy the seasonal changes in relative comfort, despite your allergies. With proper care, today nearly everyone can survive allergy season without a lot of distress.
Written by Jonna Jefferis, Davis Vision. Originally appeared in April 2008.
Food Poisoning - Eating Can Make You Sick.
Did you know that the Centers for Disease Control and Prevention (CDC) estimates that about 5,000 Americans die every year from something they ate? The news concerning illnesses caused by spinach and by eating at some fast-food restaurants in the past year have made us think about food safety. By handling, preparing and storing food properly, you can help protect your family at home.
In this article, we will talk about three types of food poisoning: salmonella, botulism and E. Coli infection.
Salmonella.
Most of us know about salmonella bacteria. The most common form of exposure to salmonella bacteria is food poisoning. Every summer, we hear reminders about leaving milk, dairy products, foods with mayonnaise, and processed meats outside and exposing these foods to the heat. Salmonella bacteria is found in these foods and improper handling can make you sick. And they can also make your pets sick as well. Salmonella is also common in foods that contain raw eggs or undercooked chicken and turkey.
Food poisoning symptoms, such as diarrhea, fever, chills, nausea, vomiting and abdominal cramps, usually occur within eight to 48 hours after eating contaminated food. In most cases, the symptoms will last about three to five days and you do not need medical treatment. If you have severe symptoms, the symptoms last longer than five days, if you are pregnant, if you have a chronic disease such as diabetes, or your child has symptoms, dehydration becomes a serious risk. In these cases, you should talk to your physician.
Salmonella bacteria is killed by cooking food thoroughly. You should wash your hands after handling raw meat and also clean the kitchen counters with disinfectant to prevent spreading salmonella.
Botulism.
Botulism food poisoning, caused by another type of bacteria, requires immediate medical care. One form of botulism is a rare but serious food illness caused by eating foods that contain the botulism toxin. Around 100 cases of food botulism are reported in the US every year, usually the result of eating contaminated home-canned food.
Symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth and muscle weakness. Infants may appear lethargic, have a poor appetite, are constipated, have a weak cry and poor muscle tone.
Symptoms generally appear 18-36 hours after eating contaminated food. The botulism toxin can cause muscle paralysis and respiratory failure. That is why it is important to seek medical care immediately if you suspect you are infected.
E. Coli Infection.
E. Coli can also cause food poisoning. Most types of E. Coli bacteria live harmlessly in our digestive tracts. Disease causing E. Coli spreads to humans by contact with human or animal feces that is in contaminated food or in contaminated water.
Eating contaminated, undercooked ground beef is the way most people in the US become infected with E. Coli. E. Coli can also spread by raw meat contact with your hands, cooking utensils, cutting boards and other food preparation surfaces. Raw fruits and vegetables, such as lettuce, spinach, and alfalfa sprouts and unpasteurized juices, like apple cider, that have contact with animal feces also cause E. Coli infections.
E. coli can also be spread person-to-person through direct contact or shared food when an infected person does not properly wash his/her hands.
Symptoms can develop within eight days of exposure, however most of the time symptoms appear within three to four days. The diarrhea usually lasts about one week in adults and up to three weeks in children. It is important to prevent dehydration caused by the diarrhea. The infection will usually go away on its own. However, if you develop a severe blood problem like anemia or kidney problems, you need to see a physician immediately.
What Can You Do?
• Boil home-canned foods for ten minutes before eating. High temperatures destroy the botulism toxin so this will help to ensure safe food.
• To prevent botulism in infants, do not give honey to children until they are one year old.
• Bacteria can get into your cooked food if the cooked food touches a dirty utensil or countertop that was used to prepare the uncooked meat. It is important to wash your hands, utensils and countertops before and after you handle raw meat and when you prepare fresh fruits and vegetables.
• Do not use the food in dented or damaged cans.
• Make sure dairy products you eat and drink have been pasteurized.
• Wash your hands after you go to the bathroom or touch animals.
• Rinse fresh vegetables and fruits before you eat or cook them.
• Thaw frozen poultry in the refrigerator before you cook it. Do not let it stand at room temperature.
• Heat foods to the appropriate temperature. Pork should be heated to an internal temperature of at least 160° F and poultry should be heated to an internal temperature of 170° F. Never partially cook meat or poultry and then finish cooking it later.
• Refrigerate leftover meat, seafood, dairy products, eggs and poultry as soon as possible. Do not let these items sit out of the refrigerator for longer than two hours.
• Buy produce that is not bruised or damaged.
• If you buy pre-packaged produce, like bagged lettuce or spinach, a half of melon, pre-cut fruit and vegetables, make sure the items are in the refrigerated area of the produce section.
• Bag fresh fruits and vegetables separately from meat, poultry and seafood.
• Store perishable fresh fruits and vegetables in your refrigerator. This includes strawberries, lettuce, herbs, mushrooms and produce that is pre-cut or pre-peeled.
• You may want to disinfect cutting boards and countertops periodically. You can also run sponges and plastic or non-porous cutting boards through the dishwasher after use.
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally published in March 2007. Resources include Blue Health Connection (Food Poisoning and Cover Story from October 30, 2006) and www.webmd.com (Food Poisoning and Safe Food Handling).
Immunizations - Part Of Your Good Health.
Why are immunizations so important? Many dangerous childhood diseases such as measles, mumps, German measles or rubella, whooping cough, chickenpox, polio, and tetanus may cause permanent disability or death. It’s important to begin your child’s immunizations and complete all the necessary boosters to protect them from these diseases.
Your teenage children and you should also keep up-to-date with some immunizations to protect against diseases such as tetanus and the flu.
Your Children.
Childhood immunizations are responsible for the control of many infectious diseases that were once common in the US. While the US has near record lows of the number of cases of vaccine-preventable diseases, the viruses and bacteria that cause the diseases still exist. Vaccines prevent disease in immunized individuals and help protect individuals who come in contact with unvaccinated individuals.
In January 2007, the American Academy of Pediatrics released its “Recommended Immunization Schedules for Children and Adolescents – United States 2007.” This publication reflects the current recommendations for the use of vaccines licensed by the Food and Drug Administration (FDA). It includes charts that summarized the recommended immunization schedules for children age 0 through six, children age seven through eighteen, and for children and adolescents who start the process late or more that one month behind schedule.
Here is a summary of the vaccination needs of children and teens.
Age, birth,
Hepatitis B Vaccine.
Age, 1 to 2 months,
Hepatitis B Vaccine.
Age, 2 months,
Rotavirus, first dose.
Diphtheria, Tetanus, and Whooping Cough.
Haemophilus influenzae type b.
Polio.
Pheumococcal conjugate.
Rotavirus.
Age, 4 months,
Hepatitis B Vaccine (depends on type of initial vaccine).
Diphtheria, Tetanus, and Whooping Cough.
Rotavirus.
Haemophilus influenzae type b.
Polio.
Pheumococcal conjugate.
Rotavirus.
Age, 6 months,
Rotavirus.
Diphtheria, Tetanus, and Whooping Cough.
Haemophilus influenzae type b (depends on type of initial vaccine).
Pheumococcal conjugate.
Rotavirus.
Age, 6 to 8 months,
Hepatitis B Vaccine.
Polio.
Age, 12 to 15 months,
Haemophilus influenzae type b.
Pheumococcal conjugate.
Measles, mumps & rubella.
Chickenpox.
Age, 12 to 23 months,
Hepatitis A.
Age, 15 to 18 months,
Diphtheria, Tetanus, and Whooping Cough.
Age, 4 to 6 years,
Diphtheria, Tetanus, and Whooping Cough.
Polio.
Measles, mumps & rubella.
Chickenpox.
Age, 11 to 12 years,
Diphtheria, Tetanus, and Whooping Cough.
HPV (females only).
Meningococcal conjugate.
For a copy of the actual publication, please refer to the American Academy of Pediatrics web site, www.aap.org, under the immunizations feature. As with all types of medical care for your family, you should discuss your child’s immunization schedule with your physician.
(Please note: When you choose the link above, you are leaving fepblue.org and going to a new web site. We do not endorse this site nor do we make any guarantees about the accuracy and content of the site. Protection of your privacy at the new site is governed by the privacy policy of that site. Therefore, please take time to read the privacy policy of the new site.)
Adults.
Most adults receive the majority of immunizations during childhood. However, vaccines are not just for children.
It is important for adults to keep up-to-date on tetanus and diphtheria immunizations with a booster shot every ten years. In addition, a flu immunization each fall or winter may help protect you from getting the flu and reduce your chance of getting complications, such as pneumonia, if you do get the flu. You may also want to get a pneumonia immunization. If you did not have measles, mumps or chickenpox during childhood or the vaccines to prevent them, you may consider getting these immunizations as well since these diseases in adults are often very serious and can cause permanent disability or death.
You should discuss any immunizations with your physician to see what vaccines are right for you.
Your Service Benefit Coverage Helps.
Your Service Benefit Plan coverage provides benefits for preventive care for both adults and children. Benefits for preventive care are paid in full under both Basic and Standard Option when you use a Preferred provider.
Adult care includes benefits for one flu vaccine every flu season, a pneumonia vaccine, Herpes Zoster or shingles vaccine and a tetanus-diphtheria booster once every ten years. Care for children includes routine services recommended by the American Academy of Pediatrics for children up to the age of 22. Please see the 2008 Service Benefit Plan brochure for a complete list of covered preventive care.
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally published in July 2007. Resources include the 2007 Blue Cross and Blue Shield Service Benefit Plan brochure (RI 71-005), the American Academy of Pediatrics web site www.aap.org under the immunization topic, the Childhood Immunization Support Program (CISP) which is a partnership between the American Academy of Pediatrics and the Centers for Disease Control and Prevention, and Blue Health Connection under Immunizations for Prevention.
MRSA: Resistance To Antibiotics.
MRSA has been in the news quite a bit in the past year. A recent report by the Centers for Disease Control and Prevention indicated that there were more deaths from MRSA in 2006 than from AIDS.
Methicillin-resistant Staphylococcus aureus or MRSA are staph infections that have become resistant to treatment by the antibiotics normally used for these infections such as methicillin, oxacillin, penicillin and amoxicillin. This resistance to normal treatment methods makes MRSA a serious health issue.
What Are Staph Infections.
Staph infections are caused by the Staphylococcus aureus bacteria. If you puncture or injure your skin, the staph bacteria can enter the wound and cause an infection. Usually, these are minor infections treated by keeping the wound clean and covered. Rarely, the infection becomes more serious and spreads to deep tissues of the body or enters your blood.
Who Is At Risk?
Most staph infections, including MRSA infections, usually occur in individuals with weakened immune systems who are hospitalized or in other types of healthcare facilities such as nursing homes. MRSA infections that occur in healthy individuals who have not been hospitalized nor had a medical procedure within the last year are called Community Associated MRSA infections.
In October 2007, the Centers for Disease Control and Prevention (CDC) issued a statement about MRSA in schools. Other areas and situations that make it easier for the transmission of MRSA were also identified and include crowds, dormitories, military barracks, gyms, households and day care centers. MRSA in these situations is usually transmitted by direct skin contact or contact with shared items, such as towels, or surfaces that have come into contact with the infection.
What Are The Symptoms?
Staph infections often begin as a pimple, abscess or boil that is red, swollen and painful. The area around the initial site can also be tender and warm to the touch. The pimple or boil can have pus and drain fluid. These signs of infection can be near an open wound or sore. Sometimes there is no wound or break in the skin near these symptoms. If the infection spreads, you may develop a fever. If red lines develop, the infection is spreading and you need to seek immediate medical attention.
Generally, antibiotics can be used to treat staph infections. However, as indicated above, MRSA infections are resistant to many of the antibiotics traditionally used to treat staph infections.
There are several more potent antibiotics physicians can now use to treat MRSA infections. But if the infection goes too deep, involving muscles and other tissue, the area of infection may have to be surgically cleaned.
If you think you have a staph infection, you need to consult your physician as soon as possible for medical treatment.
Safety Tips.
The staph bacteria is transmitted by direct skin-to-skin contact, by sharing an item such as a towel, or by touching a bandage that has had contact with another person’s infection. The infection is contagious if it is oozing fluid or draining.
To prevent the transmission of staph bacteria, it is important to follow these steps:
1. Practice good hygiene by washing your hands thoroughly and frequently with soap and water or use an alcohol based hand sanitizer.
2. Clean scrapes and cuts to your skin and keep them covered with clean dry bandages until they are healed. Use an antibiotic ointment to help with healing. If you have a staph or MRSA infection, it is important that you cover the wound with clean, dry bandages to prevent transferring the infection.
3. Do not touch the cuts or bandages of others.
4. Avoid sharing personal items, such as towels, washcloths, clothing, bed linens or razors, which come in contact with bare skin.
5. Develop a cleaning protocol by establishing cleaning procedures for frequently touched surfaces and surfaces that come into contact with bare skin.
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally published in March 2008. Resources: www.cdc.org, Invasive MRSA Fact Sheet; www.webmd.com, Health News October 24, 2007.
Prostate Cancer.
Prostate cancer is the second must common form of cancer in men in the US. In terms of cancer related deaths, only lung cancer causes more deaths among men.
As men live longer, more men are screened for prostate cancer, diagnosed and treated. In the past few years, the survival rate for prostate cancer has increased from 67 percent to 97 percent.
Overview Of Prostate Cancer.
Prostate cancer is the abnormal growth of cells in a man’s prostate gland. Most men who get it are 65 years of age or older and most cases are curable because they are found before the cancer spreads to other parts of the body. About 90 percent of prostate cancer is found in the early stages and the survival rate for these cases is almost 100 percent.
What causes prostate Cancer? It is believed to be a combination of heredity and other factors. If you have close relatives who have or had prostate cancer, your risk is higher than normal. This is especially true if it occurred at an early age and multiple relatives have prostate cancer. Risk is also greater when close relatives have breast cancer.
Your diet may also be related to prostate cancer. Men who eat more fat and red meat may be more likely to get prostate cancer. Eating cooked tomatoes, even in spaghetti sauce or on pizza, and eating broccoli, cauliflower, brussel spouts and cabbage may lower your risk. Some medical conditions, such as sexually transmitted diseases and frequent or chronic inflammation of the prostate gland may also increase risk.
Most prostate cancer grows very slowly. So, in most cases, you do not have any symptoms of prostate cancer, even after you have been diagnosed. However, if the cancer spreads or gets worse you can have some symptoms such as:
• Trouble urinating, including pain, trouble stopping or starting, or blood in your urine. But, these are also very common symptoms of other health problems like urinary tract infections. So, just because you have these symptoms don’t think that you have prostate cancer.
• Fatigue and loss of appetite, including anemia.
• Pain in your hip, lower back or thighs which may indicate that the cancer has spread to these areas and has weakened your bones.
Prostate Specific Antigen (PSA) Test.
Almost 75 percent of all men over the age of 50 have had a prostate specific antigen (PSA) test. About 54 percent have the test done regularly as part of their routine physical.
Recently, there has been some controversy over the PSA test. The American Cancer Society recommends that both a PSA test and digital rectal exam be offered every year beginning at age 50 to all men who can be expected to live at least ten years. As the risk for African American men and men with a family history of prostate cancer is higher, these men should start earlier, usually at age 45. The Centers for Disease Control and Prevention (CDC) don’t recommend routine or annual PSA tests because it has not been proven that early screening saves lives. Further the US Preventive Services Task Force says that there isn’t enough evidence to recommend getting the routine PSA test or not getting the test. The test can have false-positive results and cause unnecessary anxiety and additional medical tests and treatments.
However, it spite of this controversy, most physicians agree that the PSA test is an important diagnostic tool. You should discuss your concerns with your physician. Your physician can help you decide if the PSA test is right for you now or in the future.
What We Pay.
Benefits are available under Standard and Basic Option coverage for PSA tests. When you use a Preferred provider, benefits for the test are paid in full. For more information about preventive care benefits, please refer to the 2008 Service Benefit Plan brochure.
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally published in July 2007. Resources include the 2007 Blue Cross and Blue Shield Service Benefit Plan brochure (RI 71-005), www.webmd.com topic of prostate cancer, and Blue Health Connection Cover Story dated September 18, 2006.
Are You At Risk For A Stroke?
How much do you know about strokes? Did you know that women are more likely to die from a stroke than breast cancer? If you are a man, did you know that you are more likely to have a stroke at a younger age? About 2,000 people suffer a stroke every day in the US. So, it’s important to know the risk, the symptoms and what you can do to help prevent a stroke.
What Is A Stroke?
When the blood supply to your brain is suddenly reduced or stopped, a part of your brain is damaged. This is called a stroke. The part of your brain that is damaged can no longer function.
There are several types of stroke that prevent blood from getting to your brain.
• A thrombotic stroke occurs when a blood clot forms in an artery and blocks blood flow to your brain.
• An embolic stroke occurs when a blood clot or piece of plaque breaks away and flows through the blood stream blocking an artery in the brain.
• A lacunar stroke is caused by a blockage in certain small blood vessels in the brain.
• A cerebral hemorrhage occurs when an artery in the brain bursts or tears. This causes bleeding in the brain.
Are You At Risk?
There are many factors that increase your risk of a stroke. High blood pressure is the leading risk factor in having a stroke. People with high blood pressure are at least four times more at risk for a stroke than people without high blood pressure. It can cause weak points on artery walls to stretch, break and bleed into the brain.
People who smoke double their risk of having a stroke. Smoking injures blood vessel walls and promotes hardening of the arteries. If you quit smoking, your risk decreases after about four years of not smoking.
If you have atherosclerosis, or hardening of the arteries, you also have a higher risk of a stroke. With this disease, your arteries harden and narrow because of plaque buildup in artery walls. These arteries are often brittle and prone to cracking, which can cause bleeding in your brain.
In addition, your risk is almost doubled if you have diabetes because of the circulation problems associated with this disease. High cholesterol levels lead to coronary artery disease which can damage the heart muscle and increase your risk of a stroke. Using some medication, such as birth control pills, especially in women who smoke or a history of blood clotting problems, can increase the risk of stroke. Heavy use of alcohol, particularly binge drinking, and use of illegal drugs can also increase your risk.
In addition, you should check out your family history of stroke to see if that will increase your risk.
What Are The Symptoms?
Strokes occur in people of all ages. About one third of all strokes occur in people under the age of 65.
Symptoms of a stroke vary depending on the part of the brain affected and the extent of damage to the brain. The symptoms can occur suddenly or progress over time. For example, you may notice a weakness in your arm or the inability to move your leg.
Symptoms following a stroke include:
• A severe headache with no known cause.
• Weakness, numbness or tingling in the face, arm or leg, especially on one side of the body.
• Trouble walking, dizziness, and loss of balance or coordination.
• Inability to speak or difficulty speaking or understanding.
• Trouble seeing or double vision.
• Confusion.
• Difficulty moving arms and legs, or swallowing.
• Loss of consciousness.
Women may have some symptoms that are different than those men experience. This includes face pain, sudden hiccups, sudden nausea, sudden chest pain or sudden shortness of breath.
You may also experience Transient Ischemic Attacks or TIAs prior to a stroke. TIAs are temporary loss of some function of the brain that appear with out warning and the effects disappear within 24 hours. TIAs can be caused by arteriosclerosis or narrowing of the blood vessels in the brain. When small pieces of plaque break off from a blood vessel wall and block a small blood vessel, this can also cause a TIA. The symptoms are similar to that of a stroke.
What To Expect When You Have a Stroke.
If you or someone near you is experiencing any of the symptoms of a stroke or TIA, call 911 immediately! This is a case where every minute counts. Treatment is more effective and a better recovery can be expected if treatment is given as soon as possible.
To determine whether or not you have had a stroke, the hospital or your doctor will probably order some diagnostic tests, including lab tests, an EKG, a chest X-ray and CT or MRI of your brain.
The hospital may keep you for observation for 24 hours. Your physician may prescribe bed rest and oxygen. The problem that caused the stroke, such as high blood pressure or diabetes, will also be treated. Once you are alert and able to exercise, your rehabilitation program may begin. This will include physical therapy to help strengthen your muscles and teach you how to move with any damaged muscles, occupational therapy to help you relearn ways of eating and dressing, and speech therapy if you have any problems swallowing, speaking or understanding words.
Most people survive a stroke. However, your health and recovery will need management. Your recovery depends on the extent of damage done to your brain. You may see some improvements within the first few weeks after your stroke. Other improvements, such as muscle movement and speech, may take longer. Your physician will discuss all of the recovery process with you and explain what you can expect.
What Can You Do?
You can help prevent a stroke.
You can control your high blood pressure with medication and by following the instructions for taking the medication. If you take other medications, including over-the-counter drugs, discuss this with your physician. If you smoke, quit. Eat a balanced, nutritious, low-fat diet to decrease your risk of developing fatty deposits in your blood vessels. Exercise every day. Limit your alcohol consumption. And keep a healthy weight.
Discuss any concerns with your physician especially if you are at risk. Your physician can help you plan any lifestyle changes, such as diet, exercise, programs for stress management and smoking cessation programs.
What Are My Benefits?
Your Service Benefit Plan coverage provides benefits for the health care you need when you suffer a stroke. Benefits are available for ambulance care to the emergency room, inpatient hospital care, inpatient physician care, and the inpatient diagnostic tests you may need. Benefits are also available for outpatient services you may require for your recovery, such as physical, occupational and speech therapy.
For a complete description of benefits, see Section 5 in the 2008 Service Benefit Plan brochure (RI 71-005). Remember if you have Basic Option coverage, you must use Preferred Providers. If you have Standard Option coverage, your out-of-pocket expenses will be lower if you use Preferred Providers.
Need More Information?
You can get more information about strokes and helping people who have had a stroke online at:
Please note: When you choose the links below, you are leaving fepblue.org and going to a new web site. We do not endorse this site nor do we make any guarantees about the accuracy and content of the site. Protection of your privacy at the new site is governed by the privacy policy of that site. Therefore, please take time to read the privacy policy of the new site.
• The National Stroke Association, www.stroke.org.
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally appeared in the September 2006 issue of Straight Talk. Resources include the Service Benefit Plan brochure, Blue Health Connection, see Clinical Reference System under Stroke and Transient Ischemic Attack, www.webmd.com, see the Stroke Center, and the National Stroke Association, see Women and Stroke.
Preventing Hepatitis.
What Do All Those Letters Mean?
In the United States, the rate of new Hepatitis A and Hepatitis B cases is declining due in part to immunizations for these viruses. However, there are still about 30,000-40,000 new cases of Hepatitis C every year. Did you know that Hepatitis rates are higher among Asian-Americans than any other group? Your lifestyle and your job may also put you at risk.
Hepatitis is an infection by a virus that affects the liver. As a result of the infection, your liver becomes tender and swollen. The infection may destroy some parts of your liver before you recognize the symptoms of Hepatitis or have any symptoms at all.
Hepatitis is spread by different types of viruses. The most common types are Hepatitis A, Hepatitis B and Hepatitis C. If you are already infected with Hepatitis B, you can also have Hepatitis D. Hepatitis E is another virus that can cause Hepatitis.
The viruses that cause each type of Hepatitis are spread in different ways.
Hepatitis A:
This virus is spread by fecal matter or intimate contact with an infected person. Although it occurs frequently in areas with poor sanitation, it can also be spread when you don't wash your hands after going to the bathroom then handle food others are going to eat. You can also get this virus by eating shellfish taken from contaminated waters.
Hepatitis B:
Hepatitis B is spread through blood, usually from sexual contact or by sharing infected needles. An infected mother can pass Hepatitis B to her baby at birth or you can get this type of Hepatitis if infected tools are used for a tattoo or body piercing. Using illegal drugs also increases your risk. Hepatitis B can be a short-term or long-term infection and it can be severe and sometimes fatal. This Hepatitis virus is the most easily spread form.
Hepatitis C:
Hepatitis C can lead to cirrhosis, liver cancer and liver failure. It is also spread through infected blood contact. The most common way to get Hepatitis C is sharing needles and other equipment while using illegal drugs. It can also be spread to a baby during the birth process. Hepatitis C can be spread by people, called carriers, who do not have an active infection. Like Hepatitis B, Hepatitis C can be short-term (acute) or long-term (chronic) infection.
Hepatitis D:
This virus only exists if you have Hepatitis B and is found in the patient's blood. Hepatitis D can increase the severity of Hepatitis B.
Hepatitis E:
Hepatitis E is normally in developing countries and is spread through contaminated water. It is not common in the United States.
Symptoms:
The symptoms of Hepatitis may appear two weeks to six months after you are exposed to the virus through contact with a person with an active Hepatitis infection. Or you may never have any symptoms that point to the infection and be diagnosed only after you have some liver damage. Further, there are individuals who carry the Hepatitis virus but never have any symptoms.
The symptoms, when they do appear, are similar to other conditions, such as the flu. They include:
• Loss of appetite.
• Fever.
• General aches.
• Fatigue.
• Hives.
• Painful joints.
• Nausea and vomiting.
• Darkened urine.
• Yellowish skin and eyes.
Diagnosis and Treatment.
If you are exposed to Hepatitis, you should contact your physician as soon as possible. You will need to discuss your symptoms with your physician and how you think you were infected. The sooner Hepatitis is diagnosed, the better your chances of surviving Hepatitis without damage to your liver. Your physician may also perform some blood tests and urine tests to check your liver function.
Once your condition is diagnosed, ask your physician about an appropriate diet, discuss any medications you may currently be taking for other conditions, and discuss appropriate activity during your recovery.
Treatment usually includes getting lots of rest and eating a healthy diet. In addition, you should avoid alcohol and certain medicines that are metabolized in the liver. You will probably not be admitted to the hospital for treatment. Recovery lasts about one to six months, but Hepatitis can reoccur although it will generally be milder than the initial infection.
Prevention.
Hepatitis A and B vaccinations can prevent these two types of infection. Your Service Benefit Plan coverage provides benefits for Hepatitis A and Hepatitis B immunizations for patients with increased risk or a family history of Hepatitis A or B. Under Standard Option, you pay a $15 co-payment for the related office visit and nothing for the immunization when you use a Preferred physician. If you have Basic Option and use a Preferred primary care provider, you pay a $20 co-payment and nothing for the immunization.
There is no vaccine for the most common type of Hepatitis, Hepatitis C.
You can avoid spreading Hepatitis by washing your hands after using the bathroom and avoid sharing toothbrushes and razor blades with others. If you are close to someone with Hepatitis, you can protect yourself by washing clothing and bed linens with a detergent that kills germs, and clean toilets and other surfaces with a disinfectant.
More Information.
If you would like more information about Hepatitis, you can talk to your physician. The following online resources are also a good source of information:
• www.webmd.com. (Please note: When you choose this link, you are leaving fepblue.org and going to a new web site. We do not endorse this site nor do we make any guarantees about the accuracy and content of the site. Protection of your privacy at the new site is governed by the privacy policy of that site. Therefore, please take time to read the privacy policy of the new site.)
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally appeared in the May 2006 issue of Straight Talk. Resources include the Service Benefit Plan brochure (RI 71-005), Blue Health Connection, see the Clinical Reference System under Viral Hepatitis, Hepatitis A, Hepatitis B, and Hepatitis C, www.webmd.com, see Hepatitis A, Hepatitis B, and Hepatitis C.
Meningococcal Vaccine.
Are You Covered?
Service Benefit Plan benefits are now available under both options for a meningococcal vaccine.
Each year, about 3,000 people die from meningococcal meningitis. Meningococcal meningitis is a form of meningitis caused by specific bacteria which causes swelling of the brain or spinal cord. Symptoms include a fever, headache and a stiff neck. Nausea, aching muscles and skin rashes may also occur. Even though it can be treated with antibiotics and other drugs, it can cause permanent brain damage and hearing loss.
Getting immunized is important for teens entering high school and college students living in dormitories. Some colleges even require this immunization. Unfortunately, many only hear about the vaccine when their child already has the disease or a local college reports some students have the disease.
Talk to your physician about getting your teenage or college age children vaccinated with the meningococcal immunization.
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally appeared in the March 2006 issue of Straight Talk. Resource is the Service Benefit Plan brochure (RI 71-005) and www.webmd.com, see Meningitis.
What You Should Know About Kidney Disease.
What Do Kidneys Do For You?
One in nine American adults, about 20 million people, has chronic kidney disease. It is the ninth leading cause of death - more than 50,000 people die of kidney disease every year. With an aging population as well as an increase in the number of cases of diabetes and high blood pressure, kidney disease is getting more common. However, early diagnosis and treatment can help prevent kidney failure.
Your two kidneys keep your blood clean and chemically balanced. They also make hormones that grow the red blood cells in your bone marrow, help keep your bones strong and regulate your blood pressure.
Your kidneys filter about 200 quarts of blood every day. They retain what is necessary and remove waste and extra fluids from your body. The waste and water become urine.
Are You At Risk?
Do you have diabetes or high blood pressure? These two conditions cause about two thirds of all cases of kidney disease and are the most common causes.
There are also some risk factors you cannot control. If you are over 60 years of age, you may have a greater risk of kidney disease. African-Americans, Hispanics, Asians and Pacific Islanders also have a greater risk. Do you have a family history of kidney disease? This puts you at greater risk of getting kidney disease. And men have a higher risk than women of developing chronic kidney disease.
Kidney disease is also caused by other diseases such as lupus, polycystic kidney disease and inflammation of the kidneys, as well as an injury or poisoning. In addition, medication abuse can lead to kidney disease.
What Is Kidney Disease?
Most kidney diseases attack the filtering system of the kidneys. When the kidneys can no longer function, ridding your body of waste and maintaining proper fluid and chemical balances, you get sick. Because your kidneys are not functioning properly, you may also get weak, pale and tired because your body isn't making enough red blood cells. Many people have no symptoms in the early stages of kidney disease. It can take years for the damage to become noticeable.
Some symptoms of kidney disease include:
• Loss of appetite.
• Weight loss.
• Nausea and vomiting.
• Urinating more or less often.
• Swollen hands, feet, or belly.
• Puffiness around your eyes.
• Swelling and numbness of hands or feet.
• Drowsiness and trouble concentrating.
• High blood pressure.
• Muscle cramps.
To help diagnose your condition, your physician will probably do a variety of blood, urine and other tests to determine the extent of damage to your kidneys. Treatment may be as simple as making some changes to your diet, monitoring your blood sugar levels and controlling your blood pressure.
When you have only ten percent of your kidney function, you cannot live unless you get some help for your kidneys, such as dialysis, to help filter out the waste.
What Can You Do?
Early detection is a real key in treating kidney disease. During your routine physicals, ask your physician, if he/she does not do this already, to take your blood pressure, test your urine for a protein call albumin and test your blood for creatinine. Other preventive measures include:
• Maintain a healthy weight, which can also prevent other diseases such as diabetes, high blood pressure and heart disease.
• Maintain a blood pressure of less than 130 over 80 mm Hg.
• Keep your blood sugar as close to normal as possible if you have diabetes.
• Don't smoke. Smoking can lead to atherosclerosis, which reduces blood flow to the kidneys and increases blood pressure.
More Information.
There are many online resources for information about kidney disease.
• The National Kidney Foundation, www.kidney.org.
• www.kidshealth.org has information about kids and chronic kidney disease.
• The American Kidney Fund at www.kidneyfund.org provides some basics about kidney disease.
(Please note: When you choose the links above, you are leaving fepblue.org and going to a new web site. We do not endorse this site nor do we make any guarantees about the accuracy and content of the site. Protection of your privacy at the new site is governed by the privacy policy of that site. Therefore, please take time to read the privacy policy of the new site.)
Written by Paula Spurway, Blue Cross and Blue Shield Association. Originally appeared in the January 2006 issue of Straight Talk. Sources include Blue Health Connection see the cover story March 14, 2005 and the Clinical Reference System under Urine, webmd.com, see Chronic Kidney Disease, and the National Kidney Foundation, see Important Facts About Diabetes and Kidney Disease.